Managing dyslipidemia in older adults

To summarize and critically review clinical trial data regarding dyslipidemia as a risk factor for coronary heart disease (CHD) and the efficacy and safety of lipid-lowering interventions in older adults. Based on these data, clinical recommendations for diagnosing and managing dyslipidemia in older adults are provided.

Peer-reviewed journal articles were identified by a MEDLINE search and a review of journal article references. Studies that were performed exclusively in subjects older than 65 years or that included a large subgroup of older adults were included.

Elevated low density lipoprotein and total cholesterol levels are independent risk factors for CHD events in patients aged older than 65 years. Older adults have a higher risk of mortality attributable to hypercholesterolemia. Diet and lipid-lowering medications safely and effectively lower cholesterol levels in this age group. Exercise increases high-density lipoprotein cholesterol levels and decreases triglyceride levels. If accompanied by weight loss, exercise may reduce low-density lipoprotein and total cholesterol levels. Improving lipid levels in older adults with CHD decreases the risk of future coronary events by up to 45%, and significant effects on outcome measures may be observed within 2 years of the initiation of therapy.